Healthcare Provider Details
I. General information
NPI: 1508401001
Provider Name (Legal Business Name): 5280 ELEVATED HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/08/2019
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
884 S QUIETO WAY
DENVER CO
80223-2630
US
IV. Provider business mailing address
884 S QUIETO WAY
DENVER CO
80223-2630
US
V. Phone/Fax
- Phone: 303-717-8037
- Fax: 303-785-8084
- Phone: 303-717-8037
- Fax: 303-785-8084
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
BETH
ALANA
CALIX CASTRO
Title or Position: REGISTERED NURSE/OWNER
Credential: RN, BSN.
Phone: 303-717-8037